A bread recipe to fight cancer
Jacob Schor, ND
May 25, 2007
I spent the winter of 1972 learning to bake bread and frost birthday cakes at Laney Community College in Oakland, California . My wife sometimes admits that the first time she watched me make butter-cream roses for a birthday cake was a turning point in our relationship. Those thirty something years ago, our goal in bread making was to produce loaves that rivaled machine made wonder bread. The art of artisan bread baking was not in our vocabulary..
Back then, breads were pretty much all straight dough, even when I switched to making wholegrain breads with the Tassajara Bread Book as my bible, the dough was still ‘straight.' In this context, ‘straight' means that all the ingredients were mixed together at the same time. You mixed, kneaded, proofed, shaped, proofed again and baked. It was straight forward and produced homogenous textured and relatively bland flavored breads.
The Jewish sour rye breads we made at my grandfather Maurie Penn's bakery in East LA were a different story, they were far from straight. These breads were ‘built' off a sour starter that was saved from the prior batch of bread. The term ‘built' refers to the successive ferments of starter that were fed, mixed, fermented and fed again, or built up over twenty four hours until a final dough was mixed last thing in the evening and left to rise until the night baker arrived to shape, proof and bake off the loaves in a brick hearth shortly after midnight. Although he took pride that his bakery was one of the first union shops in California , the bakers provided by the union, came close to killing the business. The union would send journey men bakers but few had a clue how to build the breads Maurie's, customers, mostly Jewish delicatessens across Los Angeles , demanded.
Today, ‘built' breads are all the rage. These are the ‘artisan breads' that strive to imitate the rustic looking breads produced by Old World bakeries. These are no quick twenty four hour builds either; Peter Reinhart, my current guru of bread baking, lays out formulas in his book, Crust and Crumb, that require four and five day builds. These repeated ferments break down the wheat flour and change the chemistry responsible for the flavor and texture of the finished breads. Writers like Reinhart use the words paradigm shift when addressing this change from straight to built breads.
The simple version of this ‘new' build technique is to start bread a day early with a ‘poolish.' Rather than mixing all of the ingredients together at the same time, a soft sponge using some of the flour, water and a little yeast is mixed and allowed to ferment overnight before adding the salt and additional flour to make up the final dough. The poolish is soft, about the consistency of pancake batter. This extended fermentation alters the protein and starch in the flour yielding a bread with far richer flavor, coarser texture and a crisper flakier crust. Most commercial bakeries still prefer making straight dough breads, not only do built breads demand more time and labor, but long ferments sometimes go astray. These extended fermentations produce something besides a better tasting loaf, they produce beneficial nutritional changes which we are only beginning to get a taste of.
I bring up this ‘paradigm shift' in baking because a number of our cancer patients have started taking a new nutritional product called Avemar. Avemar is made from fermented wheat germ. A Hungarian scientist named Máté Hidvégi invented it in 1990. The name apparently derives from some desperate ‘Hail Mary's' uttered by Hidvégi when either, his first funding grants ran out or when a benefactor agreed to provide the money he needed to continue his research. To make Avemar, wheat germ is fermented with the yeast Saccharomyces cerevisiae for about 18 hours and the resultant product dried to a powder. This end-product is standardized to contain 0.04% of methoxysubstituted benzoquinones which is probably one of several active ingredients in Avemar. Hidvégi wasn't the first Hungarian interested in benzoquinones for treating cancer. Albert Szent-Gyorgyi, better known for discovering ascorbic acid, first proposed using them as anticancer agents year earlier.
Fermenting wheat germ yields a complex brew of chemicals and there are probably other chemicals besides these benzoquinones that are active. The Avemar research focuses on its effect on cancer and immune disorders. A number of different mechanisms have been identified by which Avemar acts against cancer. They include apoptosis induction via poly (ADP-ribose) polymerase, stimulation of the immune system, effects on major histocompatability comples (MHC) class 1, ribonucleotide reductase (RNR), cyclo-oxygenase (cox1 and cox-2) enzyme activity, intracellular adhesion molecule (ICAM) 1, tumor necrosis factor alpha (TNF-a) production, and transketolase (TK). [i]
An excellent review of these mechanisms is posted at:
Numerous animal studies have demonstrated Avemar's benefit in cancer treatment. Scientists measure immune function by timing how long it takes an experimental animal to reject a skin graft from another animal. The faster the rejection, the better the immune system is working. Avemar increases immune function as measured by this skin graft test. [ii] Giving Avemar to test rats prevented them from developing colon cancer when given a cancer-causing chemical. In the rats in the control group, 83% developed tumors while only 45% of the rats given Avemar did so. [iii] In a number of animal experiments giving vitamin C at the same time as the Avemar increased the effect at inhibiting metastasis. [iv]
Even though we are still awaiting a definitive double-blinded, placebo controlled human trial, there are a number of open human trials and animal trials that certainly suggest possibility of great benefit.
In an article published in August 2003 in the British Journal of Cancer, Jakab Shoenfeld reported results from an open trial of 66 patients with colorectal cancer. The study participants received standard therapy plus 9 grams of Avemar a day. These patients were compared to 104 patients who received only standard treatment but no Avemar. The primary endpoint of the study was progression-free survival. Progression related events, including recurrent disease, metastasis, or death were more common in the control group than in those taking Avemar. In all, 42.3% of the control group had progression events while only 16.7% of the Avemar group did. This was an open trial, patients decided if they wanted to take the ‘experimental product.' They were not randomized. It appears that the sicker people were at the start of the experiment, the more inspired they were to volunteer to take the Avemar. At the start of the trial 27% of the Avemar patients had stage IV disease while in the control group only 4% were this far advanced. [v]
Event Control Group Avemar Group p value
New Recurrences 17.3% 3.0% <0.01
New Metastases 23.1% 7.6% <0.01
Deaths 31.7% 12.1% <0.01
Progression related events 42.3% 16.7% <0.001
Another study from 2004, this one published in the Journal of Pediatric Hematological Oncology, looked at the incidence of febrile neutropenia in children undergoing immunosuppressive chemotherapy. [vii] Avemar was given at the same time as chemotherapy in an open label matched-pair pilot trial. Control patients did not receive Avemar. Tumor staging was the same at the start of the study. The number and frequency of febrile illnesses was monitored and differed significantly between the two groups of patients. The Avemar patients had 30 febrile episodes in total in contrast to the control patients who had 46 episodes.
In another open-label trial, but randomized, clinical trial, Avemar was given to twenty-two patients along with chemotherapy combination DTIC to patients with stage III melanoma. They were compared against twenty-four patients who only received the DTIC. Again, there was a significant difference in favor of the patients consuming Avemar in terms of progression-free survival. [viii]
You can full text of these studies at: http://www.avemar.com/
What does this have to do with bread baking? Recall that Avemar is made from wheat germ fermented by Saccharomyces cerevisiae . That fancy named for the yeast is the same yeast commonly used for baking bread. The idea of mixing wheat germ, water and yeast together and allowing the mix to ferment for a day sounds like a remarkably like the poolish used in artisan bread baking. The only difference is that wheat germ is the base, rather than flour. Back in the days before white flour, the whole grain flours used contained wheat germ, admittedly only about 2-3% by weight, but wheat germ all the same. Eating one's daily bread probably provided a person with a daily dose of the same benzoquinones sold as the cancer fighter, Avemar.
Is Avemar something one can make at home?
Obviously the Avemar patent holders are not about to answer this question. The information revealed in published studies certainly does suggest a simple recipe: “wheat germ fermented with Saccharomyces cervisiae at 30 degrees C for 18 hours” How hard is that?
Fermented Wheat Germ Bread Recipe:
Step 1: A wheat germ Poolish:
2 cups fresh raw wheat germ
1 ½ cups spring water
½ teaspoon of dry bakers yeast
Mix ingredients together in a glass bowl, cover and leave in warm place, about 85 degrees for 24 hours.
Step II:: The Bread dough:
To the Poolish, add:
4 cups flour. A mixture of about half whole wheat and half unbleached white bread flour works well, but you can adjust the ratio to your personal preferences
1 1/2 cup water
mix until dough is formed. Let sit 20 minutes
1 Tb salt and knead until smooth and elastic, adding additional flour as needed. In a mixer this may take 10 minutes on slow.
Cover and let rise in warm place until doubled in bulk, 2-3 hours, divide in two, shape loaves, proof an additional couple of hours, again until doubled in bulk.
Bake in a hot oven, preheated to about 500 degrees, Once the bread is in the oven, reduce heat to 425 and bake until done.
[i] Integrative Medicine vol 6 no 2 April/May 2007
[ii] Immunopharmacology 1999 Apr;41(3):183-186
Hidvegi M, Raso E, Tomoskozi Farkas R, Lapis K, Szende B.
Birochem, Budapest , Hungary .
Effect of MSC on the immune response of mice
The supposed immunostimulatory actions of MSC, a new fermented wheat germ extract standardized to its benzoquinone composition (trade name: AVEMAR) were studied examining blastic transformation of peripheral blood lymphocytes of mice treated with MSC. It was found that MSC significantly increased the degree of blastic transformation caused by Concanavalin A. Using the B10LP to C57Bl skin graft system, MSC (0.03 and 3.0 g kg(-1) applied orally) acted in favour of restoring the immune function. On the other hand, 2,6-dimethoxy-p-benzoquinone (DMBQ), applied in equivalent doses (0.012 and 1.2 mg kg(-l)), did not shorten the rejection time of skin grafts. The immune restoring effect, as well as the blastic transformation enhancing potential of MSC may be exploited in various cases of decreased immune response.
[iii] Carcinogenesis. 2001 Oct;22(10):1649-52.
Wheat germ extract inhibits experimental colon carcinogenesis in F-344 rats.
Zalatnai A ,
Lapis K ,
Szende B ,
Raso E ,
Telekes A ,
Resetar A ,
Hidvegi M .
1st Institute of Pathology and Experimental Cancer Research, Semmelweis University , Budapest , Hungary . firstname.lastname@example.org
It has been demonstrated for the first time that a wheat germ extract prevents colonic cancer in laboratory animals. Four-week-old inbred male F-344 rats were used in the study. Colon carcinogenesis has been induced by azoxymethane (AOM). Ten rats served as untreated controls (group 1). For the treatment of the animals in group 2, AOM was dissolved in physiologic saline and the animals were given three subcutaneous injections 1 week apart, 15 mg/kg body weight (b/w) each. In two additional groups Avemar (MSC), a fermented wheat germ extract standardized to 2,6-dimethoxy-p-benzoquinone was administered as a tentative chemo-preventive agent. MSC was dissolved in water and was given by gavage at a dose of 3 g/kg b/w once a day. In group 3, animals started to receive MSC 2 weeks prior to the first injection of AOM daily and continuously thereafter until they were killed 32 weeks later. In group 4 the basal diet and MSC were administered only. At the end of the experiment all the rats were killed by exsanguination, the abdominal large vessels were cut under a light ether anesthesia and a complete autopsy was performed. Percentage of animals developing colon tumors and number of tumors per animals: group 1 - 0 and 0; group 2- 83.0 and 2.3; group 3 - 44.8 (P < 0.001) and 1.3 (P < 0.004), group 4 - 0 and 0. All the tumors were of neoplastic nature also histologically. The numbers of the aberrant crypt foci (ACF) per area (cm(2)) in group 2 were 4.85 while in group 3 the ACF numbers were 2.03 only (P < 0.0001).
PMID: 11577004 [PubMed - indexed for MEDLINE]
[iv] Anticancer Res. 1998 Jul-Aug;18(4A):2353-8.
Effect of Avemar and Avemar + vitamin C on tumor growth and metastasis in experimental animals.
Hidvegi M ,
Raso E ,
Tomoskozi-Farkas R ,
Paku S ,
Lapis K ,
Szende B .
Birochem Ltd., Budapest , Hungary . BIROCHEM@MAIL.DATANET.HU
Because of the observed immunostimulatory actions of a new fermented wheat germ extract--with standardized benzoquinone composition--we have investigated the eventual tumor growth- and metastasis-inhibiting effects of this preparation (Avemar) applied alone or in combination with vitamin C. Tumor models of different origin [a highly metastatic variant of the Lewis lung carcinoma (3LL-HH), B16 melanoma, a rat nephroblastoma (RWT-M) and a human colon carcinoma xenograft (HCR25)]--kept in artificially immunosuppressed mice were applied. The metastasis-inhibiting effects of the treatments have been studied both in the presence and in the absence (following surgical removal) of the transplanted primary tumors. Combined treatments with Avemar and vitamin C--administered synchronously--profoundly inhibited the metastasis formation in all the applied tumor models while, treatments with vitamin C alone did not exert such an inhibiting effect on the metastasizing process. The degree of the observed metastasis inhibition in certain models was significant, while in others--although it was meaningful--did not prove to be significant. It is noteworthy that treatment with Avemar alone in certain models exerted a more pronounced inhibiting effect on metastasis formation than the synchronous combined treatment with Avemar and vitamin C. Furthermore, if the time schedule of the combined treatment was changed (vitamin C--instead of being administered synchronously--was given one hour after the treatments with Avemar), the vitamin C rather decreased the metastasis inhibiting effect of Avemar. It should be mentioned however, that in the case of rat nephroblastoma, a different response was observed: while, in the case of synchronous combination significant inhibition of metastasis formation was observed, treatment with Avemar alone did not produce metastasis-inhibition. It is noteworthy that in this model the metastasis-inhibiting effect of the synchronous combination treatment proved to be even more pronounced if Avemar was administered in a 100 times smaller dose than its regularly applied dosage. Treatment with Avemar and vitamin C--administered in combination or separately--in the majority of experimental models (with the exception of rat nephroblastoma) did not inhibit the growth of the primary tumors. It is reasonable, therefore, to suppose that in the observed metastasis-inhibiting effect the eventual proliferation inhibiting effect of these remedies does not play an important role. According to the results of other experiments--carried out in our laboratory in parallel with those described here--Avemar proved to have a meaningful immunostimulatory effect. It might therefore be suggested that the observed metastasis-inhibiting effect of this preparation may be mainly due to its immunostimulatory properties. The possible therapeutic benefits of Avemar and Avemar plus vitamin C are also discussed.
[v] Br J Cancer. 2003 Aug 4;89(3):465-9.
A medical nutriment has supportive value in the treatment of colorectal cancer.
* Jakab F,
* Shoenfeld Y,
* Balogh A,
* Nichelatti M,
* Hoffmann A,
* Kahan Z,
* Lapis K,
* Mayer A,
* Sapy P,
* Szentpetery F,
* Telekes A,
* Thurzo L,
* Vagvolgyi A,
* Hidvegi M.
Department of Surgery and Vascular Surgery, Uzsoki Teaching Hospital of Budapest , Hungary .
MSC (Avemar) is a medical nutriment of which preclinical and observational clinical studies suggested an antimetastatic activity with no toxicity. This open-label cohort trial has compared anticancer treatments plus MSC (9 g once daily) vs anticancer treatments alone in colorectal patients, enrolled from three oncosurgical centres; cohort allocation was on the basis of patients' choice. Sixty-six colorectal cancer patients received MSC supplement for more than 6 months and 104 patients served as controls (anticancer therapies alone): no statistical difference was noted in the time from diagnosis to the last visit between the two groups. End-point analysis revealed that progression-related events were significantly less frequent in the MSC group (new recurrences: 3.0 vs 17.3%, P<0.01; new metastases: 7.6 vs 23.1%, P<0.01; deaths: 12.1 vs 31.7%, P<0.01). Survival analysis showed significant improvements in the MSC group regarding progression-free (P=0.0184) and overall survivals (P=0.0278) probabilities. Survival predictors in Cox's proportional hazards were UICC stage and MSC treatment. Continuous supplementation of anticancer therapies with MSC for more than 6 months is beneficial to patients with colorectal cancer in terms of overall and progression-free survival.
PMID: 12888813 [PubMed - indexed for MEDLINE]
[vi] Orv Hetil. 2005 Sep 11;146(37):1925-31
[Fermented wheat germ extract in the supportive therapy of colorectal cancer]
[Article in Hungarian]
* Farkas E.
Biromedicina Elso Magyar Rakkutatasi Reszvenytarsasag, Budapest . email@example.com
The role of the product in the treatment of colorectal cancer is reviewed in the light of experimental and clinical results to date. The fermented wheat germ extract (code name: MSC, trade name: Avemar) registered as a dietary food for special medical purposes for cancer patients to complement the active oncotherapy, exerted a growth inhibitory effect in HCR-25 human colon carcinoma xenograft, and had a synergistic effect with 5-FU in mouse C-38 colorectal carcinoma. The product is capable of chemoprevention of colon carcinoma in F-344 rats. One of the most significant underlying mechanism is a highly cancer cell specific induction of caspase-3 mediated cleavage of PARP. In the frame of supportive therapy, fermented wheat germ extract proved to be efficient in the treatment of colorectal cancer in humans. 30 patients following radical operation were treated with standard postoperative therapy, 12 of them were given fermented wheat germ extract as additive treatment: following a 9 month long administration, no new distant metastases were detected, in contrast to 4 out 18 treated with standard therapy alone. Out of 34 patients following radical surgery and treated with chemotherapy, 17 who were given fermented wheat germ extract, achieved an improved survival rate. In the frame of a controlled multicenter open label cohort study, 170 colorectal cancer patients received anticancer therapies (chemo/radiotherapy) completed with fermented wheat germ extract in 66 of them. Results (fermented wheat germ extract vs. control): new recurrences: 3.0% vs. 17.3% (p < 0.01); new metastases: 7.6% vs. 23.1% (p < 0.01); deaths: 12.1% vs. 31.7% (p < 0.01), progression-related events in total: 16.7% vs. 42.3% (p < 0.001). Survival analysis showed significant improvements in the fermented wheat germ extract group, regarding progression-free (p = 0.0184) and overall survival probabilities (p = 0.0278). Strong predictors of survival determined by Cox's proportional hazards were UICC stage and fermented wheat germ extract treatment. Mild gastrointestinal side effects were observed in 9 cases. Supportive application of fermented wheat germ extract in colorectal cancer is highly recommended.
PMID: 16255377 [PubMed - indexed for MEDLINE]
[vii] J Pediatr Hematol Oncol. 2004 Oct;26(10):631-5.
Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients.
* Garami M,
* Schuler D,
* Babosa M,
* Borgulya G,
* Hauser P,
* Muller J,
* Paksy A,
* Szabo E,
* Hidvegi M,
* Fekete G.
Second Department of Pediatrics, School of Medicine , Semmelweis University , Budapest , Hungary . firstname.lastname@example.org
PURPOSE: An open-label, matched-pair (by diagnosis, stage of disease, age, and gender) pilot clinical trial was conducted to test whether the combined administration of the medical nutriment MSC (Avemar) with cytotoxic drugs and the continued administration of MSC on its own help to reduce the incidence of treatment-related febrile neutropenia in children with solid cancers compared with the same treatments without MSC. METHODS: Between December 1998 and May 2002, 22 patients (11 pairs) were enrolled in this study. At baseline, the staging of the tumors was the same in each pair (mostly pTNM = T2N0M0), with the exception of two cases in which patients in the MSC group had worse prognoses (metastasis at baseline). There were no significant differences in the average age of the patients, the length of treatment time (MSC) or follow-up, the number of patients with central venous catheters, the number of chemotherapy cycles, the frequency of preventive counterneutropenic interventions, or the type and dosage of antibiotic and antipyretic therapy used in the two groups. RESULTS: During the treatment (follow-up) period, there was no progression of the malignant disease, whereas at end-point the number and frequency of febrile neutropenic events significantly differed between the two groups: 30 febrile neutropenic episodes (24.8%) in the MSC group versus 46 (43.4%) in the control group (Wilcoxon signed rank test, P < 0.05). CONCLUSIONS: The continuous supplementation of anticancer therapies with the medical nutriment MSC helps to reduce the incidence of treatment-related febrile neutropenia in children with solid cancers.
PMID: 15454833 [PubMed - indexed for MEDLINE]
[viii] Demidov LV et al.
Antimetastatic effect of MSC in high-risk melanoma patients
18 th UICC International Cancer Congress, Oslo , Norway 30 June-5 July, 2002. Int J Cancer2002;100(S13):408